Task 2 Flashcards
Specific phobia
-DSM criteria
A. anxiety about specific object or situation
B. phobic object or situation provokes immediate fear
C. actively avoided
D. out of proportion
E. 6 months or more
F. causes impairment
G. not another mental disorder
Specific phobia
-subtypes
- animal
- situational (flying, enclosed spaces)
- natural environment (heights, dark)
- BII (needles, blood)
- other (clowns, choking, vomit)
Specific phobia
-3 components of process of anxiety (borkovec)
1) motoric escape and avoidance
2) physiologic activation of sympathetic branch ANS
3) cognitive appraisal of threat and harm
Specific phobia
-differential diagnosis
- Social phobia: content of fear network is interpersonal in nature
- PD with agoraphobia: panic response itself distinguished from specific phobia
- PTSD: its occurrence requires a direct experience
- OCD: obsessions are far more chronic and repetitive
Specific phobia vs agoraphobia
- specific phobia, situational type: one situation is feared
- agoraphobia: two or more sitations that are feared
when avoid or fear more than one situation but situations belong to the same cluster than specific phobia
Systematic desentization (wolpe)
- aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter conditioning.
- First patients is taught a muscle relaxation technique and breathing excercises
- second patient creates a fear hierarchy
- third the patient works their way up the fear hierarchy
- induction of relaxation not necessary so has fallen out
Exposure in vivo therapy
-3 phases
- instruction phase: given a plausible model and explanation why fear was maintained. role of avoidance explained and mechanisms of change
- direct in vivo exposure: approach feared object and stay in position until the fear is reduced by at least 50%
- maintenance of results: practicing at home using self-exposure techniques
Applied tension
- for exposure in BII
- trained to identify the earliest signs of bradycardia and drop in blood pressure, and then tense the body muscles to increase blood pressure and prevent fainting
- combines muscle tension with in vivo exposure
Two-phase (biphasic) response to BII stimuli
- initial phase: increase in heart rate and blood pressure
- second phase: characterized by bradycardia and hypotension leading to fainting
Classical conditioning
-example elevator
CS (elevator) + UCS (i will die) = UCR (fear response)
CS (elevator) = UCR (fear response)
Classical conditioning
-US representation
- stimulus can activate the mental representation of itself
- CS (barking dog) + US representation (dog attack) = CR (fear response)
Classical conditioning
-extinction
- dog slowly start to stop salvating when he hears the bell (CS) = inhibitory learning: slow decrease of response (CR) after a CS: the CR to the CS is slowly inhibited
- association not broken but new association is learned = CS-noUS association
- CS-US easily triggered by presenting only once the US after the CS = rapid reacquisition
Classical conditioning
-counterconditioning
-train the CS to predict reaction that is the opposite of the CR: relaxation
classical conditioning
-latent inhibition
- lot of experiences with CS-noUS makes it more difficult to develop a CS-US association
- vaak tandarts zonder pijn, 1x wel pijn geeft nog geen CR (pijn) want vaak geen pijn gehad
classical conditioning
-compound conditioning
- series of CS that become associated: CS itself can be predicted by another CS.
- CS1 (inside bus) - CS2 (dog enter bus) - CS3 (barking dog) - US (attack by dog)
classical conditioning
-habituation
- decrease of natural response (UR) to a stimulus (US)
- vb huilende baby (gewenning) dus minder reactie
- dishabituation: stimuls is habituated but then other externeous stimulus gets its original response back again
- vb baby+hond huilen weer wel vervelend
classical conditioning
-sensitization
- increase of UR to a US
- vb huilende baby zo vervelend dat kleinste gehuil je al geirriteerd maakt
operant conditioning
-positive reinforcement, reward
- voluntary behavior of pressing lever is reinforced by the increase of a positive consequence
- Sd (blue light) : R(pressing lever) - +Cpos (increase of food)
- discrimnative stimulus (Sd) blue light and food and (S delta) red light and no food
operant conditioning
-negative reinforcement, escape
- Sd (blue light) : R (pressing lever) - -Cneg (decrease of shock)
- S delta (red light) : R (pressing lever) - no change, stil shocked
- Sd (dog leased): R (running away) - -Cneg (decrease of fear)
- Sdelta (dog unleased): R (running away) - no change and panic
Operant conditioning
-negative reinforcement, avoidance
- Sd(blue light): R(pressing lever) - 0Cneg (hold of shock)
- Sdelta (red light): R(pressing lever) - no shock
- Sd (in park): R(walking away) - 0Cneg (hold of catastrophe)
- Sdelta (home): R(walking away) - no attack possible
- safety behavior: making sure catastrophe not occur 0Cneg but refers to behavior to stay in anxiety situation (CS)
operant conditioning
-punishment of avoidance response
- Short term: drop anxiety (-Cneg), holding of catastrophe (0Cneg), attention loved ones (+Cpos)
- long term: decrease radius of action (-Cpos), increase fear intensity (+Cneg), starting new education (0Cpos)
Two factor model of mowrer
-maintenance of anxiety disorders
- through operant conditioning, CS-US associations shaped by classical conditioning remain intact and are remained
- electricity cut off, but keeps pressing lever so will not learn that it is broken and shock will not appear
- VB umbrella to holding of tigers
- CS (no umbrella), R(keeping umbrella up), US (attack by tigers), reinforcement of R (0Cneg holding of tigers)
two factor model of mowrer
-exposure
-to change the classical conditioning CS-US association you need to take away the avoidance behavior (R) learned by operant conditioning
-inhibition of R (staying with the dog)
CS (barking dog) - noUS (safe no dog attack)
Return of fear in anxiety
-5 ways
- rapid reacquisition: presenting CS-US together again
- US reinstatement: experience with the US alone
- Renewal: returning of fear when change in context
- spontaneous recovery: just by passing time anxiety can suddenly return
- disinhibition: an extraneous stimulus is presented
